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以青年为中心的研究,旨在帮助预防和减轻巴布亚新几内亚年轻人怀孕对健康和社会造成的不利影响。

Youth-centred research to help prevent and mitigate the adverse health and social impacts of pregnancy amongst young Papua New Guineans.

作者信息

Bell Stephen, Kennedy Elissa, Black Kirsten, Vallely Andrew, Vallely Lisa, Mola Glen, Kaldor John, Bagita Mary, Ninnes Caroline, Pomat William, Kelly-Hanku Angela

机构信息

a Senior Research Fellow , Kirby Institute, UNSW Sydney , Sydney , Australia.

b Visiting Fellow, Centre for Social Research in Health , UNSW Sydney , Sydney , Australia.

出版信息

Reprod Health Matters. 2018 Nov;26(54):5-12. doi: 10.1080/09688080.2018.1512297. Epub 2018 Sep 27.

Abstract

Despite persistent international attention, adolescent pregnancy remains a major public health concern in low- and middle-income countries, like Papua New Guinea (PNG), where health inequities related to social and cultural norms, gender power imbalance, education and socio-economic deprivation affect young and unmarried women in particular. In PNG - where there is high adolescent fertility, high early childbearing and high maternal mortality ratio, and evidence of high rates of unintended pregnancy and abortion among young women - adolescent pregnancy is a policy priority. Yet there are no youth-specific sexual, reproductive and maternal health services or community-based outreach programmes. There is limited in-depth qualitative data on young women's and young men's experiences of pregnancy, the social contexts within which these pregnancies occur, young people's contraception practices and experiences with existing sexual, reproductive and maternal health services. These issues inhibit the design and delivery of youth-friendly health services and outreach support programmes that could prevent or mitigate adverse health and social outcomes associated with adolescent pregnancy. In this commentary article, we propose the need for novel youth-centred research to inform the development of policies, health services and outreach programmes that pay honest and respectful attention to young people's lived experiences of pregnancy. Whilst we focus on the situation in PNG, these ideas are relevant to diverse low resource settings where the harmful impacts of health inequities among young people persist and are particularly detrimental.

摘要

尽管国际社会一直予以关注,但在巴布亚新几内亚等低收入和中等收入国家,青少年怀孕仍然是一个重大的公共卫生问题。在这些国家,与社会文化规范、性别权力失衡、教育及社会经济贫困相关的健康不平等现象尤其影响年轻未婚女性。在巴布亚新几内亚,青少年生育率高、早育率高、孕产妇死亡率高,且有证据表明年轻女性意外怀孕和堕胎率很高,青少年怀孕是一项政策重点。然而,该国没有针对青少年的性健康、生殖健康和孕产妇健康服务,也没有基于社区的外展项目。关于年轻女性和年轻男性的怀孕经历、这些怀孕发生的社会背景、年轻人的避孕措施以及他们在现有性健康、生殖健康和孕产妇健康服务方面的体验,深入的定性数据有限。这些问题阻碍了设计和提供对青少年友好的健康服务及外展支持项目,而这些项目本可预防或减轻与青少年怀孕相关的不良健康和社会后果。在这篇评论文章中,我们提出需要开展以青少年为中心的创新性研究,为政策制定、健康服务及外展项目的发展提供信息,这些政策、服务和项目要切实且尊重地关注年轻人怀孕的实际经历。虽然我们关注的是巴布亚新几内亚的情况,但这些想法适用于各种资源匮乏的环境,在这些环境中,年轻人健康不平等的有害影响持续存在且危害极大。

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